GastroIntestinal / Gastroenterology News

Godstone Farm in Surrey has closed to visitors while the Health Protection Agency leads the investigation into an outbreak of E Coli 0157 among people who have visited there.

The Agency’s Surrey and Sussex Health Protection Unit (HPU) is working with local environmental health officers, the Veterinary Laboratory Agency and Godstone Farm in response to 36 cases of gastrointestinal illness which have occurred following visits to the animal farm in Surrey.

Of the 36 cases, 12 children are currently in hospital with complications arising from the infection which causes diarrhoea and can lead to kidney failure, especially in young children.

Measures to reduce the risk of the infection spreading were put in place by the farm last week but as more cases have been reported, the farm has agreed to close to enable detailed investigations into the source of the infection. During the peak of the school holidays, the farm which allows people to see and pet a variety of farm animals, receives up to 2,000 visitors a day.

Dr Angela Iversen, Director of the Health Protection Unit, said: “This is a large outbreak of this infection. The farm owners are co-operating fully and we are working closely with them and with colleagues across health and local authorities to investigate the source. Our advice is that the farm should remain closed to visitors while this work goes on.”

It is believed the outbreak began around August 8th. Anyone who visited the farm since that date, or any member of their household, even if they did not personally visit the farm, who becomes unwell with the following symptoms should seek medical advice or contact NHS Direct on 0845 4647:

- diarrhoea (which can be bloodstained)
- vomiting
- fever
- abdominal pain and cramps
- feeling weak or lethargic
- passing less urine than usual
- pallor
- fits

Dr. Iversen added: “We are urging parents to follow strict hand washing with their families when visiting these farms. Although many parents may carry alcohol gels with them, this should be an adjunct to hand washing with soap and water and not a substitute.

“Eli 0157 is an infection that people can pick up when handling or stroking animals, unless hands are thoroughly washed afterwards to minimise the risk. It can also be spread easily from person to person so good hygiene is vital, especially in young children whose hand washing after using the toilet and before eating should be supervised. ”

Notes

- E coli 0157 bacteria usually cause diarrhoea which settles within seven days without treatment. The diarrhoea may contain blood. Occasionally, serious kidney and blood complications can occur. Good hygiene is very important in preventing person-to person spread and small children should be supervised with hand washing after using the toilet and before eating.

- Escherichia coli (commonly referred to as E. coli) is a species of bacteria commonly found in the intestines of humans and animals. There are many different types of E. coli, and while some live in the intestine quite harmlessly, others may cause a variety of diseases. The bacterium is found in faeces and can survive in the environment.

- To avoid getting strains capable of causing intestinal disease people should avoid eating undercooked meat, in particular inadequately cooked minced beef and avoid drinking unpasteurised milk. Individuals working with uncooked meats or on farms should pay close attention to good hygiene practices, as should visitors to farms.

- It is important to always wash your hands with soap after going to the toilet and before and after handling food.

- Hand washing in young children should be supervised, especially after handling animals or their surroundings, for instance on a visit to a farm.

Source
Health Protection Agency Continue reading →

Could the bacteria that we carry in our bodies decide who we marry? According to a new study from Tel Aviv University, the answer lies in the gut of a small fruit fly.

Prof. Eugene Rosenberg, Prof. Daniel Segel and doctoral student Gil Sharon of Tel Aviv University’s Department of Molecular Microbiology and Biotechnology recently demonstrated that the symbiotic bacteria inside a fruit fly greatly influence its choice of mates.

The research was done in cooperation with Prof. John Ringo of the University of Maine, and was recently published in the Proceedings of the National Academy of Sciences (PNAS).

Love, marriage and fruit flies

Based on a theory developed by Prof. Rosenberg and Dr. Ilana Zilber-Rosenberg, the scientists propose that the basic unit of natural selection is not the individual living organism, plant or animal, but rather a larger biological milieu called a holobiont. This milieu can include plant or animal life as well as their symbiotic partners. In the case of animals, these partners tend to be microorganisms like intestinal bacteria.

“Up to now, it was assumed that the host organism undergoes evolution on its own, while its symbiotic bacteria undergo their own evolution,” Prof. Rosenberg says. “The mechanism that we discovered enables evolution to occur more rapidly in response to environmental changes. Since a generation is shorter for bacteria than for multicellular organisms, they genetically adjust more quickly to changes in the holobiont,” says Prof. Rosenberg.

Conducting their experiments on the rapidly-reproducing fruit fly, the scientists were able to test this new theory. The first experiment repeated a study carried out two decades ago by a Yale University researcher, in which a fly population was divided in half and fed different diets – malt sugar versus starch. A year later, when the flies were re-integrated as one group, those who had been fed starch preferred starch-fed mates, while the sugar-fed flies preferred mates of a similar nutritional background. The repeat experiment carried out by the Tel Aviv University researchers shows that this dietary influence takes effect within just a generation or two rather than over an entire year.

In their second experiment, the Tel Aviv University team repeated the first, but with the addition of an antibiotic, which killed the bacteria and eliminated the specific mate preference. The mating process became random, with no dietary influence.

In subsequent experiments, the researchers successfully isolated the bacterial species responsible for reproductive isolation in flies with diet-related mating preferences, and found the bacteria Lactobacillus plantarum to be present in greater numbers in starch-fed fruit flies than in sugar-fed flies. When L. plantarum was reintroduced into the antibiotic-treated flies, the preferential mating behavior resumed – proving that this bacterial species is at least partly responsible for the mating preference.

Rewriting Darwin?

Finally, in cooperation with Prof. Avraham Hefetz of Tel Aviv University’s Department of Zoology, the team analyzed the sexual pheromones produced by the fruit flies. There turned out to be differences in pheromone levels between the two groups of flies – differences that again disappeared after administering antibiotics.

“The finding indicates that pheromone alterations are a mechanism by which we can identify mating preferences. We therefore hypothesize that it is the bacteria that are driving this change,” Prof. Rosenberg says. He adds that these discoveries have implications for our entire understanding of natural selection – something which may even lead to the development of a new theory of evolution.

Source:
George Hunka

American Friends of Tel Aviv University Continue reading →

W. L. Gore & Associates (Gore) today announced at the 35th annual VEITHsymposium™ in New York that it has received regulatory clearance from Health Canada’s Therapeutic Products Directorate to market the GORE EXCLUDER AAA Endoprosthesis and GORE TAG Thoracic Endoprosthesis in Canada. Planning is underway for Canadian physician training on the devices, and the subsequent commercial product release timeline will be announced in the near future. The GORE EXCLUDER AAA Endoprosthesis and the GORE TAG Thoracic Endoprosthesis devices are the leading options for less invasive treatment of abdominal aortic aneurysm (AAA) and thoracic aortic aneurysm (TAA) in North America. The GORE EXCLUDER AAA Endoprosthesis and the GORE TAG Thoracic Endoprosthesis were previously granted regulatory approval in the US, Europe, Japan and South Korea.

The GORE EXCLUDER AAA Endoprosthesis is an implantable device indicated for the endovascular treatment of AAA, a condition caused by the degenerative weakening and dilation of the abdominal aorta. If left untreated, it can rupture and result in fatality. The GORE TAG Thoracic Endoprosthesis is an implantable device used to treat TAA, or an aneurysm of the descending thoracic aorta, the body’s main circulatory vessel. TAA is a life-threatening condition generally believed to be significantly under-diagnosed, and patients with TAA are at risk of death due to internal bleeding resulting from a ruptured aorta.

Until recently, treatment for AAA and TAA required invasive, large incision surgery and a lengthened hospital stay to repair the diseased or damaged artery. With the GORE EXCLUDER AAA Endoprosthesis and the GORE TAG Thoracic Endoprosthesis, aneurysms can be prevented from rupturing through a minimally invasive procedure, thereby reducing the hospital stay, morbidity and mortality associated with surgery.

“Gore is pleased to expand its international efforts to improve patient care for both AAA and TAA, with less invasive treatment alternatives for the Canadian patient population,” said John Sininger, Leader of the Gore Medical Products Division. “The GORE EXCLUDER Device and the GORE TAG Device have already proven to be valuable alternatives to invasive open surgery elsewhere, and Gore welcomes the opportunity to advance less invasive endovascular therapies for aortic diseases in Canada.”

The GORE EXCLUDER AAA Endoprosthesis is an endovascular graft and stent combination that seals off the aneurysm and creates a new path for the blood to flow. The GORE EXCLUDER AAA Endoprosthesis is inserted through a small incision in the patient’s leg using a catheter-based delivery technique. Once the graft is correctly positioned in the diseased aorta, the device self-expands using radial force and metal anchors to permanently secure it to the walls of the aorta.

The GORE TAG Thoracic Endoprosthesis is a thoracic endoprosthesis that internally relines the thoracic aorta and isolates the diseased segment from blood circulation. The GORE TAG Thoracic Endoprosthesis is comprised of an ePTFE graft with an outer self-expanding nitinol support structure to combine both device flexibility and material durability. The device is inserted by a catheter delivery technique through a small incision in the patient’s groin.

About Veithsymposium™

Now in its fourth decade, VEITHsymposium™ provides vascular surgeons, interventional radiologists, interventional cardiologists and other vascular specialists with a unique and exciting format to learn the most current information about what is new and important in the treatment of vascular disease. The 5-day event features over 400 rapid-fire presentations from world-renowned vascular specialists with emphasis on the latest advances, changing concepts in diagnosis and management, pressing controversies and new techniques. Press registration details can be found at VEITHpress or contact Pauline T. Mayer at 631.979.3780 or e-mail ptmptmhcm. VEITHsymposium™ is sponsored by Cleveland Clinic (Cleveland, OH).

About W.L. Gore & Associates

The Gore Medical Products Division has provided creative therapeutic solutions to complex medical problems for three decades. During that time, more than 25 million innovative Gore Medical Devices have been implanted, saving and improving the quality of lives worldwide. The extensive Gore Medical family of products includes vascular grafts, endovascular and interventional devices, surgical materials for hernia repair, soft tissue reconstruction, staple line reinforcement, and sutures for use in vascular, cardiac and general surgery. Gore was recently named one of the best companies to work for by Fortune magazine for the 11th consecutive year. For more information, visit goremedical.

GORE, EXCLUDER®, TAG®, and designs are trademarks of W. L. Gore & Associates.

Gore & Associates Continue reading →

Scientists who last year identified a new genetic risk factor for coeliac disease, have, following continued research, discovered an additional seven gene regions implicated in causing the condition. The team, lead by David van Heel, Professor of Gastrointestinal Genetics at Barts and The London School of Medicine and Dentistry, have further demonstrated that of the nine coeliac gene regions now know, four of these are also predisposing factors for type 1 diabetes. Their research sheds light not only on the nature of coeliac disease, but on the common origins of both diseases. It is published online today (2 March 2008) in Nature Genetics.

Professor van Heel and his team, including collaborators from Ireland, the Netherlands, and the Wellcome Trust Sanger Institute, first performed a genome wide association study in coeliac disease. Genetic markers across the genome were compared in coeliac disease subjects versus healthy controls. They then assessed around 1,000 of the strongest markers in a further ~ 5,000 samples. Their results identified seven new risk regions, six of which harbour important genes critical in the control of immune responses, highlighting their significance in the development of the disease.

Coeliac disease is common in the West, afflicting around 1 per cent of the population. It is an immune-mediated disease, triggered by intolerance to gluten (a protein found in wheat, barley and rye containing foods), that prevents normal digestion and absorption of nutrients. If undetected it can lead to a number of often severe problems among them anaemia, poor bone health, fatigue and weight loss. Currently only a restricted diet can diminish symptoms.

Professor van Heel said: “So far our findings explain nearly half of the heritability of coeliac disease – now studies with many more samples from individuals with coeliac disease are needed to identify the precise causal genetic variants from each region, and understand how these influence biological processes.”

The research was funded by Coeliac UK and The Wellcome Trust.

The paper, ‘Newly identified genetic risk variant for celiac disease related to the immune response’ is published online, on 2 March 2008, in Nature Genetics.

Barts and The London School of Medicine and Dentistry offers international levels of excellence in research and teaching while serving a population of unrivalled diversity amongst which cases of diabetes, hypertension, heart disease, TB, oral disease and cancers are prevalent, within east London and the wider Thames Gateway. Through partnership with our linked trusts, notably Barts and The London NHS Trust, and our associated University Hospital trusts – Homerton, Newham, Whipps Cross and Queen’s – the School’s research and teaching is informed by an exceptionally wide ranging and stimulating clinical environment.

At the heart of the School’s mission lies world class research, the result of a focused programme of recruitment of leading research groups from the UK and abroad and a ??100 million investment in state-of-the-art facilities. Research is focused on translational research, cancer, cardiology, clinical pharmacology, inflammation, infectious diseases, stem cells, dermatology, gastroenterology, haematology, diabetes, neuroscience, surgery and dentistry.

The School is nationally and internationally recognised for research in these areas, reflected in the ??40 million it attracts annually in research income. Its fundamental mission, with its partner NHS Trusts, and other partner organisations such as CRUK, is to ensure that that the best possible clinical service is underpinned by the very latest developments in scientific and clinical teaching, training and research.

Websites
coeliac/
wellcome.ac/

icms.qmul.ac/

icms.qmul.ac/Profiles/Gastro/van%20Heel%20David.htm

nature/ng/index.html

Source: Sally Webster

Queen Mary, University of London Continue reading →

Patients with the condition commonly known as heartburn may benefit from lifestyle interventions rather than just medication, suggest researchers in this month’s British Journal of General Practice (BJGP).

Gastro-oesophageal reflux disease (GORD) affects between 20% and 40% of the population in the western world and 32 million prescriptions for proton pump inhibitors (PPIs) were issued in 2008 in the UK at a cost of ??220 million a year.

Researchers from Bucks New University in Middlesex and Kings College London are suggesting that an educational programme for GORD sufferers, perhaps offered by nurses in primary care, might make a difference in reducing the amount of medication used.

The study gave 42 people being prescribed medication for GORD symptoms a 1.5 hour educational session each week over four weeks, then interviewed them on their symptoms and their affect on their lives after three months. Participants were encouraged to record their symptoms, look at their diet, learn about managing stress, set goals for themselves and identify their three biggest problems relating to GORD.

The authors write: “Following the intervention, patients felt more in control, believed that their treatment could help them, experienced fewer symptoms, were less concerned about their illness and had a greater understanding of and were less affected by their reflux than before the intervention.

“The intervention improved patients’ perception of their illness at three months, and improved their illness experience in many areas including testing patients’ sense of control, perception and understanding of their condition, and also symptom severity.

“There was no improvement in symptoms that prevent patients from eating or drinking what they like, which may reflect the fact that, despite reporting symptoms, patients did not let these interfere with what they wanted to consume anyway.”

Br J Gen Pract 2010; 60: 891-896).

Also in this month’s BJGP

Stanton and colleagues provide a valuable overview of the evidence guiding clinical decision making in patients with respiratory tract symptoms and infections, and offer a series of practical suggestions aimed at improving their management

In their study from Oslo, Hoye and co-workers discovered that deferred prescribing was not always endorsed by GPs, and emphasise the need for careful negotiation and the provision of information to patients when issuing wait-and-see prescriptions.

A non-drug approach to the management of hypertension is also explored in a systematic review from Ireland suggesting that patients have an important role to play in the effective management of this condition

The BJGP’s golden anniversary is marked in the Back Pages by a series of short pieces by all but one of its editors, tracing the development of one of the world’s oldest and most influential primary care publications.

Source: Royal College of General Practitioners

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Radiologists at Duke University Medical Center have developed a scale called the Duke Abdominal Assessment Scale (DAAS) to assist clinicians in determining the severity of disease and the need for surgery in infants with necrotizing enterocolitis (NEC), according to a study in the November issue of the American Journal of Roentgenology.

NEC is a serious disease that causes infection and inflammation of the intestines in infants, primarily those that are premature. Its cause is unknown however it is one of the leading causes of surgical intervention in preemies and has a death rate of 25 percent.

“The DAAS provides a standardized 10-point radiographic scale that increases with disease severity,” said Caroline L. Hollingsworth, M.D., lead author of the study. For every 1-point increase in the DAAS score, patients are more likely to have severe disease and more likely to need a surgical intervention,” she said.

Researchers performed a case-control study of 43 infants to assess whether the DAAS could serve as a clinically useful tool for predicting disease severity in neonates and infants with clinically suspected NEC. “We found that the use of a standardized scale like the DAAS may enable earlier detection of patients at risk for developing severe NEC by creating a clear, concise radiology report that provides the clinician with a consistent measure of concern by the radiologist. We also found that improved communication through standardized reporting using an accurate scale like the DAAS may affect medical decision making in a positive way and hasten the accurate identification of patients in need of intense medical surveillance or surgical intervention,” said Dr. Hollingsworth.

“Our study suggests that using the DAAS score when interpreting abdominal X-rays in neonates and infants with clinically suspected NEC may help guide increased level of clinical concern and monitoring for advanced NEC. Radiographic monitoring of disease progression and heightened clinical awareness through improved communication via the DAAS system has been a tremendous help to our clinicians at Duke,” she said.

Source:
Heather Curry

American Roentgen Ray Society Continue reading →

In a study testing the safety and efficacy of treatment
with tribendimidine for intestinal worm infections,
researchers have published some positive results. The group -
comprising of researchers from the Swiss Tropical Institute in
Basel, the National Institute of Parasitic
Diseases (IPD) in Shanghai, the Yunnan Institute of Parasitic Diseases
in Simao, China, and the Jiangsu Institute of Parasitic Diseases in
Wuxi, China – shows that this new Chinese drug is more successful than
the standard albendazole for the treatment of hookworm, large
roundworm, whipworm, threadworm, and tapeworm. Full results of
the study are published in the open-access journal PLoS
Neglected Tropical Diseases.

Over one billion people around the world have some type of intestinal
worm infection (or intestinal helminth infection). Often they lead to
problems in child and maternal
health, nutritional status, physical performance, and cognitive
development.
If people had access to safe water and sanitation, many of these
intestinal worm infections would become less prevalent. In reality,
infections are usually handled using drugs that reduce morbidity.
Currently there are four drugs that the World Health Organization
recommends for treating helminth infections transmitted by soil. This
small pool of medications means that there is a great concern that the
worms will develop resistance to the drugs.

The drug tribendimidine
is a member of a chemical class that is different than current
treatments for worm infections. Developed at IPD and Shandong Xinhua
Pharmaceutical in Zibo,
China, the drug was approved by the China State Food and Drug
Administration in 2004.

The safety and efficacy study consisted of 123 patients who were tested
for intestinal helminth infections. Researchers randomly assigned some
patients to take
tribendimidine and others to take the common albendazole treatment.
Doses were set at 200 mg for children aged 5 to 14 years and 400 mg for
individuals 15 years old and higher.

In humans situated in a highly endemic setting in China, administration
of a single oral dose of tribendimidine
cured up to 92% of the common soil-transmitted helminth infections. The
researchers also noted that the drug more effectively fought threadworm
and tapeworm infections – 55% of threadworm infections and 67% of
tapeworm infections were cured after treatment with tribendimidine.
Further, the medication reduced the infection intensity of large
roundworms and hookworms. Among the final study cohort, the researchers
did not find any adverse treatment-related events.

Repeated dosing should be tested, and results should be validated with
larger samples in various epidemiological settings in order to further
improve treatment outcomes, note the authors.

Tribendimidine and Albendazole for Treating Soil-Transmitted
Helminths, Strongyloides stercoralis and Taenia
spp.: Open-Label Randomized Trial
Steinmann P, Zhou X-N, Du Z-W, Jiang J-Y, Xiao S-H, et al.
PLoS Neglected Tropical Disease (2008). 2(10): e322.
doi:10.1371/journal.pntd.
Click
Here to View Article

About PLoS Neglected Tropical Diseases

PLoS Neglected Tropical Diseases (plosntds/)
is a
peer-reviewed, open-access journal devoted to the pathology,
epidemiology, prevention, treatment, and control of the neglected
tropical diseases, as well as public policy relevant to this group of
diseases. All works published in PLoS Neglected Tropical
Diseases are
open access, which means that everything is immediately and freely
available subject only to the condition that the original authorship
and source are properly attributed. The Public Library of Science uses
the Creative Commons Attribution
License, and copyright is retained by the authors.

About the Public Library of Science

The Public Library of Science (PLoS) is a non-profit organization
of scientists and physicians committed to making the world’s
scientific and medical literature a freely available public resource.
For more information, visit plos

: Peter M Crosta

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The somatostatin analog octreotide LAR (SandostatinR LARR) can retard tumor progression in patients with metastatic neuroendocrine midgut tumors, according to interim results of a phase IIIb trial reported here at the American Society of Clinical Oncology’s 2009 Gastrointestinal Cancers Symposium.

The study, conducted at 18 cancer centers in Germany, found that octreotide LAR was associated with a 66 percent reduction in the risk of disease progression compared with placebo after six months of treatment (p=0.000072).

“Octreotide LAR should be considered the standard of care in patients with newly diagnosed, functionally active or inactive, well-differentiated metastatic midgut neuroendocrine tumors and a low hepatic tumor load,” Rudolf Arnold, MD, with Philipps University in Marburg , Germany, said.

Dr. Arnold was the principal investigator of the trial, known as PROMID (Placebo-Controlled Prospective Randomized Study on the Antiproliferative Efficacy of Octreotide LAR in Patients with Metastatic Neuroendocrine Midgut Tumors).

He noted at a news conference that the standard treatment option for patients with metastatic midgut neuroendocrine tumors, a rare gastrointestinal tumor, is surgery. Additional options include hepatic embolization in the event of liver metastases or radioligand therapy. However, both approaches are associated with significant side effects, he added.

The trial included 85 treatment-na??ve patients with histologically confirmed locally inoperable or metastasized well-differentiated neuroendocrine tumors and a Karnofsky index greater than 60.

About 70 percent of patients had surgery before enrolling in the trial to remove the primary tumor, while the remainder had more advanced, inoperable disease. Eighty six percent had liver metastases.

Participants were randomized to octreotide LAR 30 mg i.m. every four weeks or placebo i.m. every four weeks for 18 months or until CT- or MRI-documented tumor progression or death.

The primary endpoint was median time to tumor progression.

After six months of treatment, tumor progression was reduced in 69% of octreotide LAR-treated patients and 39% of placebo-treated patients, Dr. Arnold said.

The median time to tumor progression was 14.3 months in the octreotide LAR group and six months in the placebo group (HR=0.34, p=0.000072).

Importantly, octreotide LAR’s favorable effect was observed in patients with either functioning (hormone-secreting) or non-functioning (non-secreting) neuroendocrine tumors.

Patients who derived the most benefit were newly diagnosed patients who had a tumor load that was less than or equal to 10%, Dr. Arnold observed.

Because most patients enrolled in the trial are still alive, it is not yet possible to ascertain an overall survival benefit, he added.

The side effects related to octreotide LAR were in line with those reported in earlier studies of the drug in patients with neuroendroine tumors and included diarrhea, fatigue, fever, and bile stones. Five patients dropped out of the trial because of side effects.

“Overall, our results support the use of octreotide LAR for patients after cytoreductive surgery who have few remaining metastases,” Dr. Arnold said.

The PROMID trial is the first placebo-controlled study to test octreotide LAR for the treatment of malignant neuroendocrine tumors.

Octreotide has been used to treat the clinical syndromes associated with neuroendocrine tumors. Octreotide also substantially reduces and in many cases normalizes growth hormone and/or insulin-like growth (IGF) factor-1 levels in patients with acromegaly.

(Octreotide belongs to Novartis)

Jill Stein
Jill Stein is a Paris-based freelance medical writer.
jillstein03(at)gmail

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Attending general surgeons at Beth Israel Deaconess Medical Center (BIDMC) will be required to prove basic motor skills outside an operating room before performing laparoscopic surgery on patients.

CRICO/RMF, the Harvard medical community’s professional liability insurer, will offer “Fundamentals in Laparoscopic Surgery” (FLS) as a refresher course in January 2008. As an incentive for this voluntary program, CRICO/RMF is providing a one-time patient safety incentive to attending general surgeons who demonstrate successful completion of the FLS exam.

“We enthusiastically endorse the efforts of the general surgeons in their quest to improve and maintain their skills in laparoscopic surgery,” said Robert Hanscom, Vice President of Loss Prevention and Patient Safety. “We are grateful for the opportunity to fund this important effort for surgeons.”

In an unprecedented requirement, all BIDMC general surgeons will need FLS certification to obtain privileges in laparoscopy. This requirement for certification for privileging at BIDMC is the first time surgeons in the United States will be required to demonstrate motor skills, according to Daniel B. Jones, MD, FACS, BIDMC’s Chief of Minimally Invasive Surgery.

Laparoscopy or ‘Band-aid surgery” distends the abdomen with carbon dioxide gas. Ports the diameter of a pencil have an air seal that permits long instruments to be inserted into the abdomen without losing air. The technique of several small cuts allows patients to experience less pain, shorter hospitalization and faster recovery.

Most surgeons who trained before 1990 had no formal training. Passing the FLS exam (flsprogram) raises the bar by allowing the surgeon to show they have the skill to safely perform basic laparoscopic surgery.

“If we can ask bus drivers to pass an eye test, shouldn’t you be able to ask your surgeon to pass a skills test?” said Jones. “This requirement simply puts all surgeons on the same footing as their colleagues in terms of their skills on such basic techniques as tying knots.”

Surgeons will be tested, using a trainer box, on their proficiency to suture, cut in a circle and move objects from one location to another. In addition, an online written exam ensures cognitive knowledge of laparoscopy. The Carl J Shapiro Simulation and Skills Center (bidmc.harvard.edu/sasc) serves as the regional FLS testing site for New England.

All surgeons who complete the course successfully will receive continuing medical education credits through the Society of American Gastrointestinal and Endoscopic Surgeons and the American College of Surgeons. The FLS Patient Safety Incentive Program has been made available to all attending general surgeons insured by CRICO. Details can be viewed at rmf.harvard.edu/fls.

“I know that the program provides participants with the basic skills they should have as laparoscopic surgeons,” said Jones. “When I did it myself, I found the course serves as a refresher on rare complications and events that I may not have seen but could see in the future.” Jones predicts that FLS will become a new minimal standard for all surgeons offering basic laparoscopy to patients.

Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School, and consistently ranks among the top four in National Institutes of Health funding among independent hospitals nationwide. BIDMC is clinically affiliated with the Joslin Diabetes Center and is a research partner of Dana-Farber/Harvard Cancer Center. BIDMC is the official hospital of the Boston Red Sox.

For more information, visit bidmc.harvard.edu.

CRICO/RMF is the patient safety and medical malpractice company owned by and serving the Harvard medical community since 1976.

For more information, visit Harvard Medical School, or
Fundamentals of Laparoscopic Surgery (FLS). Continue reading →

“The recent signing of a license agreement between the CSIRO/Australian Capital Ventures Limited joint venture and Austgrains Pty Ltd has paved the way for large scale commercial crops of BARLEYmax® – unique grain developed by CSIRO using conventional plant breeding techniques,” says the Director of the CSIRO Food Futures Flagship, Dr Bruce Lee.

“It contains more than twice the amount of insoluble and soluble fibre found in wheat or oats, as well as resistant starch, which helps promote healthy digestive bacteria,” Dr Lee says.

Austgrains’ Managing Director, Warren Hannam, says the unique nutritional characteristics of BARLEYmax are a valuable addition to the range of healthy food ingredients available in Australia.

“Austgrains specialises in supplying grain and functional food ingredients to the food manufacturing industry, making BARLEYmax a perfect fit for our company,” he says.

Austgrains Pty Ltd is a private company associated with publicly listed Washington H Soul Pattinson and Company Limited and its group of companies, producing and marketing specialty ingredients such as the Nu Soya range of soy products and omega-3 oils.

BARLEYmax Business Manager, CSIRO’s Geoff Ball, says clinical testing by CSIRO Human Nutrition has shown that products made with BARLEYmax – such as breakfast cereals, muffins and breads – have a low Glycaemic Index and strong bowel health attributes.

“Further testing showed BARLEYmax has excellent processing properties and foods made with the new grain have a naturally sweet, slightly nutty taste,” Mr Ball says. “With large volumes to be produced soon by Austgrains, healthy foods made with BARLEYmax are likely to be on Australian breakfast tables in the near future.”

Source: Geoff Ball

CSIRO Australia Continue reading →